Job Overview:
The Utilization Review Specialist (Psychologists) will support our Utilization Review department by working closely with patients, insurance companies, and the entire treatment team.
Job Responsibilities:
Act as an advocate for patients to ensure their treatment needs are met.
Interact with insurance companies in a professional manner.
Complete precertification and concurrent reviews with insurance companies to obtain authorization for treatment.
Act as a resource to the medical and clinical staff for all issues relating to utilization management.
Support therapeutic team members and participate in team activities.
Perform other duties and projects as assigned.
Qualifications:
Masters in Mental Health or Psychiatric Nursing.
Independent licensure in Mental Health or Psychiatric Nursing preferred.
Must have at least 5 years of clinical experience.
Must possess strong clinical assessment skills.
Be a strong team player who works well in a collaborative-team environment.
Experience completing pre-certifications and concurrent reviews preferred.
Able to organize daily schedule and prioritize cases according to level of care and due dates.